RESUMO
An aging worldwide population demands that anesthesiologists consider geriatrics a unique subset of patients requiring customization of practice. This article reviews the current literature investigating physiologic changes of the elderly that affect pharmacokinetics and pharmacodynamics. Changes in drug absorption, distribution, metabolism, and excretion are discussed as well as the ultimate effects of medications. Implications for practice regarding specific anesthetic and analgesic drugs are addressed. Despite the immense body of research that contributes to understanding of geriatric pharmacology, elderly patients often are excluded from rigorous research trials, and further scientific investigation to inform best practices for this group of patients is needed.
Assuntos
Geriatria/tendências , Farmacologia/tendências , Idoso , Idoso de 80 Anos ou mais , Tratamento Farmacológico/tendências , Humanos , Preparações Farmacêuticas/administração & dosagem , Farmacocinética , Dinâmica PopulacionalRESUMO
Melatonin is involved in regulation of a variety of physiologic functions, including circadian rhythm, reproduction, mood, and immune function. Exogenous melatonin has demonstrated many clinical effects. Numerous clinical studies have documented improved sleep quality following administration of exogenous melatonin. Recent studies also demonstrate the analgesic, anxiolytic, antiinflammatory, and antioxidative effects of melatonin. This article reviews the principal properties of melatonin and how these could find clinical applications in care of the critically ill patients.
